Definitive radiotherapy in the management of chemodectomas arising in the temporal bone, carotid body, and glomus vagale

Purpose. To evaluate the results of treatment for 71 patients with 80 chemo dectomas of the temporal bone, carotid body, or glomus vagale who were trea ted with radiation therapy (RT) alone (72 tumors in 71 patients) or subtota l resection and RT (8 tumors) at the University of Florida between 1968 and 1998. Methods and Materials. Sixty-six lesions were previously untreated, whereas 14 had undergone prior treatment (surgery, 11 lesions; RT, 1 lesion; or bo th, 2 lesions) and were treated for locally recurrent disease. All three pa tients who received prior RT had been treated at other institutions. Patien ts had minimum follow-up times as follows: 2 years, 66 patients (93%); 5 ye ars, 53 patients (75%); 10 years, 37 patients (52%); 15 years, 29 patients (41%); 20 years, 18 patients (25%); 25 years, 12 patients (17%); and 30 yea rs, 4 patients (6%). Results. There were five local recurrences at 2.6 years, 4.6 years, 5.3 yea rs, 8.3 years, and 18.8 years, respectively. Four were in glomus jugulare t umors and one was a carotid body tumor. Two of the four patients with glomu s jugulare failures were salvaged, one with stereotactic radiosurgery and o ne with surgery and postoperative RT at another institution. Two of the fiv e recurrences had been treated previously at other institutions with RT and /or surgery. Treatment for a third recurrence was discontinued, against med ical advice, before receiving the prescribed dose. There were, therefore, o nly 2 failures in 65 previously untreated lesions receiving the prescribed course of RT. The overall crude local control rate for all 80 lesions was 9 4%, with an ultimate local control rate of 96% after salvage treatment. The incidence of treatment-related complications was low. Conclusions. Irradiation offers a high probability of tumor control with re latively minimal risks for patients with chemodectomas of the temporal bone and neck. There were no severe treatment complications. (C) 2001 John Wile y & Sons, Inc.